The combination of functional metabolic information and
anatomical data has been available since 2001, when the combined
PET/CT scanner was introduced. This technology has had
a significant impact on many medical disciplines, including cardiology
and neurology, but undoubtedly the greatest impact has
been in the field of oncological imaging. It is the ability of
PET/CT to accurately identify the anatomical location of abnormal
metabolic activity that has revolutionized the detection and
staging of many tumors....

The field of general surgery has changed dramatically over the last
ten years with the acceptance of laparoscopy as an extension of the scalpel.
Once ridiculed by most academic centers, laparoscopy has revolutionized
the management of biliary tract disease and has led to a critical
reassessment of how patients with other general surgical problems are
managed. The rapid advancement and acceptance of laparoscopy as a
part of general surgery is apparent today since most academic centers
have laparoscopic sections and many offer laparoscopic fellowships....

Cancers of the oropharynx often metastasize to upper and
middle jugular chain lymph nodes (Levels II and III), but can also
spread to retropharyngeal lymph nodes, which distinguishes them
from oral cavity tumors and must be considered when treating
oropharyngeal cancers. Tumors in this site are generally treated with
radiotherapy, as a single modality for T 1/2 or N 0/1 stages. Increas-
ingly, some of these cancers are associated with human papilloma
virus 16 infection, especially in nonsmokers.

Average annual age-adjusted cancer incidence rates were calculated for each poverty area group
in New Jersey. Included in the report are the average annual age-adjusted incidence rates per
100,000 population for all types of cancer combined and 16 cancers that are the most common
types among men and/or women, or among the leading causes of cancer death.

Harrison's Internal Medicine Chapter 95. Carcinoma of Unknown Primary
Carcinoma of Unknown Primary: Introduction Carcinoma of unknown primary (CUP) is a biopsy-proven (mainly epithelial) malignancy for which the anatomic site of origin remains unidentified after an intensive search. CUP is one of the 10 most frequently diagnosed cancers worldwide, accounting for approximately 3–5% of all cancer cases.

Staging As noted in Chap. 77, an important component of patient management is defining the extent of disease. Radiographic and other imaging tests can be helpful in defining the clinical stage; however, pathologic staging requires defining the extent of involvement by documenting the histologic presence of tumor in tissue biopsies obtained through a surgical procedure.

Harrison's Internal Medicine Chapter 105. Malignancies of Lymphoid Cells
Malignancies of Lymphoid Cells: Introduction
Malignancies of lymphoid cells range from the most indolent to the most aggressive human malignancies. These cancers arise from cells of the immune system at different stages of differentiation, resulting in a wide range of morphologic, immunologic, and clinical findings. Insights on the normal immune
system have allowed a better understanding of these sometimes confusing disorders.
Some malignancies of lymphoid cells almost always present as leukemia (i.e.

Two other features may be used to assess prognosis in B cell CLL, but neither has yet been incorporated into a staging classification. At least two subsets of CLL have been identified based on the cytoplasmic expression of ZAP-70; expression of this protein, which is usually expressed in T cells, identifies a subgroup with poorer prognosis. A less powerful subsetting tool is CD38 expression. CD38+ tumors tend to have a poorer prognosis than CD38– tumors.
The initial evaluation of a patient with Hodgkin's disease or non-Hodgkin's lymphoma is similar.

B Cell Chronic Lymphoid Leukemia/Small Lymphocytic Lymphoma: Treatment Patients whose presentation is typical B cell CLL with no manifestations of the disease other than bone marrow involvement and lymphocytosis (i.e., Rai stage O and Binet stage A; Table 105-7) can be followed without specific therapy for their malignancy. These patients have a median survival 10 years, and some will never require therapy for this disorder.

Evaluation of patients with MALT lymphoma follows the pattern (Table 105-11) for staging a patient with non-Hodgkin's lymphoma. In particular, patients with gastric lymphoma need to have studies performed to document the presence or absence of H. pylori infection. Endoscopic studies including ultrasound can help define the extent of gastric involvement. Most patients with MALT lymphoma have a good prognosis, with a 5-year survival of ~75%. In patients with a low IPI score, the 5-year survival is ~90%, while it drops to ~40% in patients with a high IPI score.

Carcinoma of unknown primary (CUP) is a biopsy-proven (mainly epithelial) malignancy for which the anatomic site of origin remains unidentified after an intensive search. CUP is one of the 10 most frequently diagnosed cancers worldwide, accounting for approximately 3–5% of all cancer cases. Most investigators do not consider lymphomas, metastatic melanomas, and metastatic sarcomas that present without a known primary tumor to be CUP because these cancers have specific stage- and histology-based treatments that can guide management. ...

Malignancies of lymphoid cells range from the most indolent to the most aggressive human malignancies. These cancers arise from cells of the immune system at different stages of differentiation, resulting in a wide range of morphologic, immunologic, and clinical findings. Insights on the normal immune system have allowed a better understanding of these sometimes confusing disorders. Some malignancies of lymphoid cells almost always present as leukemia (i.e., primary involvement of bone marrow and blood), while others almost always present as lymphomas (i.e.

Chemotherapy for lymphoma uses drugs to kill
lymphoma cells. It is called systemic therapy because
the drugs travel through the bloodstream. The drugs
can reach lymphoma cells in almost all parts of the
body.
You may receive chemotherapy by mouth, through a
vein, or in the space around the spinal cord. Treatment
is usually in an outpatient part of the hospital, at the
doctor’s office, or at home. Some people need to stay
in the hospital during treatment.
Chemotherapy is given in cycles. You have a
treatment period followed by a rest period.